Charcot-Marie-Tooth Neuropathy Type 2Z (CMT2Z)

Charcot-Marie-Tooth neuropathy type 2Z (CMT2Z) is a rare inherited nerve disease that mainly damages the long nerves of the legs and arms (peripheral nerves). It is an “axonal” neuropathy, which means the inner wire of the nerve (the axon) is harmed more than the myelin covering. CMT2Z usually starts in childhood with weakness and wasting of the muscles in the feet and lower legs, and reduced feeling in the feet. Over time, weakness can climb up the legs and later affect the hands and arms, and some people develop problems with balance, spine shape, and sometimes learning or development. The condition gets slowly worse over many years and can cause serious disability in adult life. NCBI+2malacards.org+2

Charcot-Marie-Tooth neuropathy type 2Z (CMT2Z) is a very rare, inherited nerve disease. It mainly affects the long nerves that go from the spinal cord to the feet and hands. In most people, the problem comes from a change (mutation) in a gene called MORC2. This change makes the nerve fibers slowly get weaker and thinner (axonal neuropathy). CMT2Z usually starts in childhood or the teenage years with weakness in the feet and legs, problems with walking, and less feeling in the toes. Over time it can reach the hands and sometimes causes stiffness and learning difficulties in some people. CMT2Z is lifelong, but it usually gets worse slowly, and there is no cure yet, so treatment focuses on symptoms and keeping function as good as possible. ScienceDirect+4NCBI+4

CMT2Z is caused by a change (mutation) in a single gene called MORC2 on chromosome 22. This gene makes a protein that helps control how DNA is packed, how genes are switched on and off, and how cells repair damaged DNA. When MORC2 is changed, the protein does not work normally and nerve cells cannot keep their long axons healthy. This leads to progressive damage of motor (movement) and sensory (feeling) nerves, especially in the longest nerves that go to the feet and hands, so symptoms are usually worse in the most distant parts of the limbs. Ovid+3NCBI+3ScienceDirect+3

CMT2Z follows an autosomal dominant inheritance pattern. This means a person can develop the disease if they receive one copy of the changed MORC2 gene from either parent. In some people, the mutation is not inherited but appears for the first time in that person (a “de novo” mutation). Symptoms can vary within the same family, even when people carry the same MORC2 mutation. Some children may show mainly nerve problems, while others have additional features such as growth problems, learning difficulties, or facial differences related to a wider MORC2-related disease spectrum. Frontiers+4NCBI+4pesquisa.bvsalud.org+4

Other Names

Doctors and researchers may use several different names for CMT2Z. Knowing these other names can help when you read scientific papers or lab reports:MalaCards+1

• Charcot-Marie-Tooth disease, axonal, type 2Z

• Autosomal dominant Charcot-Marie-Tooth disease type 2Z

• Autosomal dominant axonal Charcot-Marie-Tooth disease type 2Z

• Charcot-Marie-Tooth neuropathy, type 2Z

• MORC2-related Charcot-Marie-Tooth disease

All of these names describe the same basic condition: an axonal motor and sensory neuropathy caused by a MORC2 gene variant. Some papers also talk about a wider “MORC2-related disorder spectrum,” which includes CMT2Z plus related conditions with more developmental or spinal features.Frontiers+2Pedneur+2

Types

There is only one genetic type of CMT2Z (MORC2-related axonal CMT). But people can show different clinical forms. Researchers often speak about “phenotypes” (observable patterns) within the same genetic disease.PMC+2Pedneur+2

• Classic childhood-onset CMT2Z
  In this form, children develop weakness in the feet and lower legs in the first decade of life. They may trip often, have foot drop, and develop high-arched feet. Sensory loss in the feet and ankles is common. With time, weakness may spread to the hands and cause difficulty with fine movements like buttoning or writing.MalaCards+2CMT Research Foundation+2

• Infantile-onset hypotonic form
  Some babies present with floppy muscles (hypotonia) and global developmental delay. They may sit, stand, and walk later than other children. As they grow, they can develop severe weakness, scoliosis, and breathing difficulties. This infantile form overlaps with spinal muscular atrophy-like pictures in some families.Wiley Online Library+2Frontiers+2

• Developmental syndrome form (DIGFAN-like)
  Certain MORC2 variants produce a broader syndrome with developmental delay, impaired growth, facial differences, and axonal neuropathy. This is sometimes called DIGFAN syndrome, but it lies on the same MORC2-related spectrum as CMT2Z. Some patients show an “intermediate” pattern between classic CMT2Z and DIGFAN syndrome.ResearchGate+2Frontiers+2

• Late-onset or adult spinal muscular atrophy-like form
  A few adults with MORC2 variants develop slowly progressive weakness and muscle wasting that looks like a late-onset spinal muscular atrophy. However, detailed testing often reveals a sensory axonal neuropathy as well, showing that this is still part of the CMT2Z family.Authorea+2PMC+2

• Forms with marked pyramidal signs
  In some patients, there are clear signs of upper motor neuron involvement, such as brisk reflexes, spasticity, clonus, and Babinski signs. These pyramidal signs appear together with axonal neuropathy, again supporting that MORC2-related CMT can affect both peripheral nerves and central motor pathways.Frontiers+3PMC+3nature.com+3

Causes of Charcot-Marie-Tooth neuropathy type 2Z

1. Pathogenic MORC2 missense mutations
   The main direct cause of CMT2Z is a disease-causing (pathogenic) missense mutation in the MORC2 gene, where one “letter” of the DNA code is changed and the MORC2 protein is built with a different amino acid. These mutations disrupt the protein’s normal function in chromatin remodeling and DNA repair and lead to degeneration of long motor and sensory axons. NCBI+2ScienceDirect+2

2. Autosomal dominant inheritance of MORC2 variants
   In many families, CMT2Z is inherited in an autosomal dominant pattern, meaning one affected parent can pass the altered MORC2 gene to a child with a 50% chance in each pregnancy. The inherited mutation is the cause of the disease in that child, and several family members across generations may show similar distal weakness and sensory loss. NCBI+2Charcot-Marie-Tooth Association+2

3. De novo MORC2 mutations
   Some individuals with CMT2Z have a mutation that is not present in either parent. This is called a de novo mutation and arises spontaneously in the egg or sperm or early embryo. Even though there is no family history, the new MORC2 mutation in that person’s cells still causes the axonal neuropathy and can be passed on to their children. Frontiers+2Frontiers+2

4. MORC2 hotspot mutations (such as p.S87L)
   Certain specific MORC2 changes, like the p.S87L variant, are seen repeatedly in different patients and are considered “hotspot” mutations. These hotspot variants can cause particularly severe forms of CMT2Z with early onset, rapid progression, and sometimes spinal muscular atrophy-like features. The presence of such a variant is a direct genetic cause of the more aggressive phenotype. ResearchGate+1

5. MORC2 variants associated with DIGFAN-spectrum disease
   Some MORC2 mutations can cause a phenotype that overlaps CMT2Z and DIGFAN, with developmental delay, poor growth, facial differences, and axonal neuropathy. In these cases, the same gene mutation is the underlying cause, but the clinical picture is broader than “pure” CMT. This illustrates how different MORC2 variants and modifying factors can shape the final presentation. NCBI+2nature.com+2

6. Gain-of-function effects of MORC2 on chromatin remodeling
   Experimental studies suggest that some MORC2 mutations may act through a toxic “gain-of-function,” where the altered protein becomes overactive in chromatin remodeling or DNA compaction. This abnormal activity can change the expression of many genes in neurons and stress the axon’s metabolism, contributing to nerve fiber degeneration and thus to CMT2Z. ScienceDirect+2nature.com+2

7. Impaired DNA damage response in neurons
   MORC2 is an important helper in the DNA damage response, working with proteins such as PARP1 to repair DNA breaks. When MORC2 is mutated, the DNA repair process in neurons can be less efficient, which may allow damage to build up over time. Long peripheral axons are especially sensitive to such stresses, so impaired DNA repair is considered a mechanistic cause that drives the progressive neuropathy. ScienceDirect+2OUP Academic+2

8. Disrupted gene regulation in peripheral nerves
   MORC2 helps control which genes are switched on or off by changing chromatin structure. Mutations can disturb this gene regulation, leading to abnormal levels of many proteins needed for axon transport, mitochondrial function, and myelination. Over years, this mis-regulation contributes to axonal degeneration and is a molecular cause of the disease process in CMT2Z. ScienceDirect+2Wikipedia+2

9. Secondary axonal degeneration due to Schwann cell dysfunction
   Even though CMT2Z is classed as an axonal neuropathy, Schwann cells (myelin-forming cells) are closely linked with axons. Gene expression changes caused by MORC2 mutations may also disrupt Schwann cell support, leading to secondary axonal degeneration. This combined neuron-glia involvement further explains why distal nerves gradually fail. Europe PMC+2NCBI+2

10. Modifier genes and genetic background
    Not all people with the same MORC2 mutation are affected in the same way, which suggests that other genes in a person’s genome act as modifiers. Variants in genes related to mitochondrial function, axonal transport, or myelin may worsen or lessen the impact of the MORC2 mutation. These modifier genes do not cause CMT2Z by themselves but can strongly influence severity and progression. Wikipedia+2Europe PMC+2

11. Gene–environment interactions
    External factors that damage peripheral nerves, such as long-standing diabetes, alcohol misuse, or certain toxic exposures, can make symptoms much worse in someone who already has a MORC2 mutation. In these cases, the genetic cause (CMT2Z) is primary, but environmental nerve insults interact with it and speed up axon loss. Mayo Clinic+2NCBI+2

12. Neurotoxic medications
    Some chemotherapy drugs and other medications are known to cause peripheral neuropathy. In a person with underlying CMT2Z, exposure to such drugs can increase nerve damage beyond what the MORC2 mutation alone would cause. This medication-related injury does not cause the genetic disease but acts as an additional cause of worsening nerve function. Mayo Clinic+2NCBI+2

13. Nutritional deficiencies
    Deficiencies of vitamins important for nerve health, such as vitamin B12, vitamin B1, or folate, can damage peripheral nerves. When these deficiencies occur in someone with CMT2Z, they may further reduce nerve conduction and speed progression of weakness and sensory loss. Good nutrition does not remove the genetic cause but helps reduce this avoidable contributor. NCBI+2PMC+2

14. Recurrent mechanical stress on weak ankles and feet
    Because CMT2Z causes weak foot and ankle muscles, there is often abnormal walking and frequent ankle sprains or falls. Repeated mechanical strain and injuries may further damage already fragile nerves or joints. Over time, this repeated trauma acts as a secondary cause of worsening deformity and disability. NCBI+2Mayo Clinic+2

15. Spinal deformity and nerve root stress
    Some people with CMT2Z develop scoliosis or abnormal spine curves. These changes may compress nerve roots or alter posture in a way that adds extra stress to peripheral nerves. Although the scoliosis is itself a result of neuromuscular weakness, it can also become a contributor to increased pain, weakness, and nerve dysfunction. NCBI+2NCBI+2

16. Reduced physical activity due to fatigue and weakness
    As walking becomes difficult, many individuals become less active. Low activity can lead to muscle wasting, decreased circulation, and joint stiffness, which in turn worsen functional abilities. This inactivity does not cause the genetic neuropathy but is a lifestyle-related factor that can strengthen the impact of the MORC2 mutation on daily life. NCBI+2JAMA Network+2

17. Obesity and metabolic stress on nerves
    Excess body weight increases mechanical load on weak feet and legs and is often linked with insulin resistance and small blood vessel problems. These factors can stress peripheral nerves further in people with CMT2Z, amplifying the underlying axonal damage and accelerating disability. NCBI+2Mayo Clinic+2

18. Coexisting autoimmune or inflammatory neuropathies
    Rarely, a person with inherited CMT may also develop an acquired immune-mediated neuropathy, such as CIDP. In such cases, the autoimmune process acts as an additional cause of nerve damage on top of the MORC2-related axonal neuropathy, causing faster decline and more severe symptoms than expected from CMT2Z alone. NCBI+1

19. Age-related axonal vulnerability
    As people age, axons naturally become more vulnerable to damage because of mitochondrial wear and reduced repair capacity. In those with a MORC2 mutation, this age-related vulnerability acts as a background cause that contributes to the slow but steady progression seen in CMT2Z across decades. JAMA Network+2Europe PMC+2

20. Delayed diagnosis and lack of supportive care
    If CMT2Z is not recognized, people may not receive early physiotherapy, orthotic support, or avoidance of neurotoxic drugs. This lack of timely management is not a genetic cause, but it allows preventable complications like contractures, falls, and secondary injuries to accumulate, effectively becoming an important cause of increased disability in daily life. NCBI+3ScienceDirect+3Charcot-Marie-Tooth Association+3

Symptoms of Charcot-Marie-Tooth neuropathy type 2Z (15 symptoms)

1. Distal muscle weakness in the feet and lower legs
   One of the earliest symptoms of CMT2Z is weakness in the muscles around the ankles and feet. Children or young adults may trip frequently, find it hard to run, or struggle to stand on their heels. This weakness reflects loss of motor axons that control the small muscles of the distal legs. NCBI+2Europe PMC+2

2. Muscle wasting (atrophy) of the calves and intrinsic foot muscles
   Over time, the weakened muscles become visibly thinner, especially in the calves and on the top and bottom of the feet. This muscle wasting gives the legs a “stork-like” appearance in some people. It occurs because long-standing denervation prevents muscles from maintaining normal size. NCBI+2malacards.org+2

3. Foot deformities such as pes cavus or flat feet
   Many people with CMT2Z develop abnormal foot shapes. High-arched feet (pes cavus) are common, but some may have flat feet (pes planus). These deformities result from imbalances between weak and relatively stronger muscles and can make standing and walking even more difficult. NCBI+2Muscular Dystrophy Association+2

4. Distal sensory loss (reduced feeling in feet and hands)
   Loss of sensation, especially in the toes and soles of the feet, is another key symptom. People may notice numbness, tingling, or a “stocking and glove” pattern of sensory loss. This happens because the sensory axons that carry information about touch, vibration, and joint position are gradually damaged. NCBI+2Europe PMC+2

5. Impaired balance and gait ataxia
   With both weakness and sensory loss, balance becomes poor. People may walk with a wide-based, unsteady gait and have trouble walking in the dark or on uneven ground. This “sensory ataxia” is caused by the combination of distal proprioceptive loss and motor weakness. NCBI+2NCBI+2

6. Absent or reduced ankle reflexes
   On examination, doctors often find that deep tendon reflexes at the ankles (Achilles reflex) are weak or absent. This areflexia reflects damage to the sensory and motor parts of the reflex arc in the peripheral nerves and is a typical sign in CMT2Z and other CMT2 forms. NCBI+2Europe PMC+2

7. Hand weakness and intrinsic hand muscle wasting
   As the disease progresses, weakness and wasting can appear in the hands, especially in the small muscles that control fine finger movements. People may have trouble buttoning clothes, writing, or gripping small objects. This hand involvement usually follows years of leg symptoms and signals more advanced axonal loss. NCBI+2Europe PMC+2

8. Clumsiness and frequent tripping or falls
   Many children with CMT2Z are described as “clumsy.” They may drop things or bump into objects, and they fall more often than their peers. This clumsiness reflects the combination of mild weakness, poor sensation, and unsteady gait early in the disease course. NCBI+2NCBI+2

9. Leg cramps, spasms, or myokymia
   Some patients experience painful muscle cramps or spasms, especially at night or after exercise. Fine undulating movements under the skin, called myokymia, can also occur. These symptoms come from increased irritability of damaged motor axons and unstable neuromuscular transmission. NCBI+2NCBI+2

10. Scoliosis or abnormal spine curvature
    Weak trunk and paraspinal muscles, combined with imbalance and altered gait, can lead to scoliosis or other abnormal spine curvatures in some individuals. This spine deformity may cause back pain and can further affect balance and walking. NCBI+2NCBI+2

11. Fatigue and reduced endurance
    People with CMT2Z often tire easily when walking or standing for long periods. Because their distal muscles are weak and nerve signals are less efficient, basic activities require more effort. This chronic fatigue can limit school, work, and social activities even when weakness seems mild. JAMA Network+2NCBI+2

12. Neuropathic pain or discomfort
    Some patients report burning, shooting, or tingling pain in the feet or legs. This neuropathic pain results from abnormal electrical activity in damaged sensory nerves. While not universal, it can be a significant symptom in a subset of people with CMT2Z and may require specific pain management. Mayo Clinic+2NCBI+2

13. Developmental delay and learning difficulties in some cases
    In the broader MORC2 spectrum, particularly when symptoms start in infancy, children may show delayed motor milestones (sitting, standing, walking) and sometimes cognitive or learning difficulties. These features are less common in classic adolescent-onset CMT2Z but are clearly reported in infantile and DIGFAN-like presentations. pesquisa.bvsalud.org+3NCBI+3Frontiers+3

14. Hearing impairment in some individuals
    A minority of people with MORC2-related disease have been reported with hearing problems. This may be due to involvement of auditory pathways or cranial nerves in addition to the limb nerves, and it is one of the “extra-neuropathy” features that highlight the variability of CMT2Z. NCBI+2NCBI+2

15. Progressive disability and loss of independence
    Over many years, the combination of weakness, sensory loss, deformities, and balance problems can lead to difficulty with independent walking and daily activities. Some adults may need ankle-foot orthoses, walking aids, or wheelchairs for longer distances. The disease usually progresses slowly, but the long-term trend is toward increasing disability if no supportive care is given. JAMA Network+2Europe PMC+2

Diagnostic tests

Physical Examination Tests

Here are some key physical examination tests doctors use when they suspect CMT2Z or other inherited neuropathies. These are done in the clinic without machines.

1. General neurological examination
   The doctor checks muscle bulk, tone, and strength in many muscle groups; tests sensation (touch, pain, vibration, joint position); and looks at coordination and gait. In CMT2Z, the exam often shows distal weakness and atrophy, reduced vibration and position sense in the feet, and problems with balance and walking.NCBI+2pfmjournal.org+2

2. Gait observation and functional tests
   The clinician watches how the person walks, turns, and climbs onto a step. Foot drop, steppage gait, wide-based walking, and difficulty walking on heels or toes are typical findings. These simple observations give strong clues about distal neuropathy in CMT2Z.NCBI+2Mayo Clinic+2

3. Inspection of feet, hands, and spine
   The doctor looks carefully for high arches, hammertoes, calluses, hand muscle wasting, and scoliosis. These visible signs help distinguish long-standing hereditary neuropathy from acute or temporary nerve problems. In CMT2Z, foot deformities and sometimes spinal curvature are common.NCBI+2Wiley Online Library+2

4. Reflex testing
   Using a reflex hammer, the doctor tests tendon reflexes at the ankles, knees, and arms. In many neuropathies, distal reflexes are reduced or absent. In some MORC2 cases, however, brisk reflexes and Babinski signs suggest additional involvement of central motor pathways.PMC+2OUP Academic+2

Manual Examination Tests

Manual tests are bedside tests performed by hand, without electrical machines or lab equipment.

1. Manual muscle testing (MRC scale)
   The examiner asks the patient to move each limb against resistance and scores strength from 0 (no movement) to 5 (normal). In CMT2Z, distal muscles such as ankle dorsiflexors and intrinsic hand muscles usually have lower scores, helping to map the pattern of weakness.NCBI+1

2. Vibration sense testing with a tuning fork
   A vibrating tuning fork is placed on bony points such as the big toes and ankles. People with axonal sensory neuropathy feel vibration for a shorter time than healthy individuals. Reduced vibration sense is a typical early sensory sign in CMT2 and CMT2Z.NCBI+2Charcot-Marie-Tooth Association+2

3. Light touch and pinprick testing
   The doctor gently touches the skin or uses a pin to test pain sense from toes upward. In CMT2Z, sensation is often reduced in a “stocking-glove” pattern, starting at the toes and fingers and moving upward as the disease progresses.Mayo Clinic+2NCBI+2

4. Romberg and balance tests
   In the Romberg test, the person stands with feet together and eyes closed. If they sway or fall because they cannot sense their body position without vision, it suggests loss of proprioception due to sensory neuropathy. This is common in advanced CMT2Z.NCBI+1

Laboratory and Pathological Tests

These tests involve blood, genetic studies, or tissue samples. They help confirm the diagnosis and rule out other causes of neuropathy.

1. Targeted genetic testing for MORC2
   This is the most specific test for CMT2Z. A blood sample is used to sequence the MORC2 gene alone or as part of a neuropathy gene panel. Finding a known pathogenic MORC2 variant in a person with compatible symptoms confirms the genetic diagnosis.OUP Academic+2Frontiers+2

2. Expanded next-generation sequencing panels
   Sometimes, doctors order a wider panel that looks at many CMT-related genes at once, or even exome/genome sequencing. This is useful when the clinical picture is unclear or when a novel MORC2 variant needs to be discovered and classified.pfmjournal.org+2OUP Academic+2

3. Routine blood tests to exclude acquired neuropathies
   Blood tests such as glucose, HbA1c, vitamin B12, thyroid function, kidney and liver tests, and autoimmune markers do not diagnose CMT2Z directly, but they exclude common acquired causes of neuropathy (like diabetes or vitamin deficiency) that might coexist or mimic hereditary neuropathy.NCBI+1

4. Nerve biopsy (now rarely needed)
   In the past, sural nerve biopsy was used more often. In axonal CMT, it shows loss of myelinated axons with relatively preserved myelin. Today, because genetic testing is widely available, biopsy is usually reserved for atypical cases where inflammation or other pathologies must be ruled out.NCBI+2medlink.com+2

Electrodiagnostic Tests

Electrodiagnostic tests measure how well nerves and muscles work using electrical signals. They are very important for confirming an axonal neuropathy pattern.

1. Nerve conduction studies (NCS)
   Small electrical shocks are applied to nerves, and responses are recorded. In CMT2Z, motor and sensory responses are often reduced in size (low amplitudes), showing axonal loss, while conduction speeds are only mildly slowed or even normal. This pattern helps separate CMT2 (axonal) from CMT1 (demyelinating).Charcot-Marie-Tooth Association+2medlink.com+2

2. Electromyography (EMG)
   A thin needle electrode is inserted into muscles to record electrical activity. In CMT2Z, EMG shows signs of chronic denervation and reinnervation, such as large motor unit potentials and reduced recruitment. These findings confirm that weakness is due to a neuropathic, not muscle-only, process.NCBI+2pfmjournal.org+2

3. Late response studies (F-waves and H-reflex)
   These tests evaluate conduction along the whole length of motor pathways. In axonal neuropathies, responses may be absent or reduced. In CMT2Z, these studies can help document the extent of motor axon involvement and distinguish from purely spinal motor neuron diseases.NCBI+1

4. Somatosensory evoked potentials (SSEPs) in selected cases
   SSEPs measure how sensory signals travel from peripheral nerves to the brain. In some MORC2-related cases with pyramidal signs or white-matter changes, SSEPs can help evaluate both peripheral and central pathway involvement.Frontiers+2ResearchGate+2

Imaging Tests

Imaging studies do not diagnose CMT2Z by themselves, but they help assess complications and central nervous system involvement.

1. Foot and ankle X-rays
   Plain X-rays can show high arches, hammertoes, joint deformities, and sometimes early arthritis changes in the feet and ankles. These images are useful when planning orthotic support, physiotherapy, or corrective surgery for deformities caused by CMT2Z.NCBI+2Wiley Online Library+2

2. Spine X-ray or MRI
   If scoliosis is suspected, spine imaging helps measure the curve and plan treatment. In severe early-onset MORC2-related disease, significant spinal deformity may develop, and early detection can guide bracing or surgical decisions.Wiley Online Library+2Wiley Online Library+2

3. Brain and spinal cord MRI
   In many people with classic CMT2Z, brain MRI is normal. However, infantile or syndromic MORC2 variants can show white-matter abnormalities, cerebellar atrophy, or other structural changes. MRI helps document central nervous system involvement and exclude other diseases.Frontiers+2ResearchGate+2

4. Muscle MRI or ultrasound
   Imaging of muscles can show patterns of muscle wasting and fatty replacement in the legs and sometimes in the upper limbs. These patterns may support a chronic neuropathic process and help distinguish CMT2Z from primary muscle diseases. Ultrasound is a radiation-free option increasingly used in neuromuscular clinics.NCBI+2Wiley Online Library+2

Non-pharmacological treatments

1. Regular physical therapy (physiotherapy)
Physical therapy is one of the main treatments for CMT2Z. A physiotherapist uses gentle strengthening and stretching exercises to keep muscles working as well as possible and to slow down contractures (when muscles and tendons shorten). Training often includes leg and core strength, balance, and walking practice. Exercise is adjusted to the person’s level so it does not over-tire weak muscles. Over time, regular sessions can improve walking, reduce falls, and help with daily activities like climbing stairs or standing from a chair. nhs.uk+2PMC+2

2. Stretching and range-of-motion exercises
Daily stretching of ankles, knees, hips, fingers, and wrists helps keep joints moving freely. In CMT2Z, tight calf muscles and Achilles tendons are common and can lead to toe-walking and foot deformity. Slow, gentle stretches held for 20–30 seconds, several times a day, reduce stiffness and pain. Stretching can be done at home after teaching by a therapist. It is simple, low-risk, and very important for long-term comfort and mobility.

3. Balance and gait training
Because the nerves that control muscles and sensation are damaged, balance often becomes poor. Special exercises like standing on one leg (with support), walking on different surfaces, and practicing turning safely can train the brain and muscles to work together better. Therapists may use tools such as balance boards or rails. This training aims to reduce falls, build confidence when walking outside, and improve independence in daily life. Journal of Health and Allied Sciences NU+1

4. Occupational therapy (OT)
Occupational therapists focus on daily living tasks, such as dressing, writing, cooking, and using a computer or phone. In CMT2Z, hand weakness and numbness may make buttons, zippers, or pens hard to use. OT can introduce simple tools like larger-grip pens, button hooks, and adapted cutlery. They also teach energy-saving methods, like planning tasks and using proper body positions, so the person can do more while feeling less tired. Charcot-Marie-Tooth Association

5. Ankle-foot orthoses (AFOs) and foot-drop splints
AFOs are light plastic or carbon fiber braces worn inside the shoes. In CMT2Z, they help lift the foot when walking (foot drop) and keep the ankle stable. This reduces tripping and ankle sprains and makes walking smoother. The orthotist designs the brace individually, and it may be adjusted as muscles change. Using AFOs early can prevent unsafe walking patterns and reduce long-term joint stress. ScienceDirect+1

6. Special footwear and insoles
Supportive shoes with a firm heel counter, wide toe box, and non-slip soles are important. Custom insoles or arch supports can improve weight distribution and comfort, especially when there are high arches or claw toes. Proper footwear reduces pressure points, blisters, and calluses. A podiatrist can help choose shoes and monitor foot skin and nails, which is vital when sensation is reduced. ScienceDirect

7. Assistive walking devices (cane, crutches, walker)
If balance is poor or leg muscles are weak, a cane, crutches, or a walker may be needed. These devices give extra support and allow safer movement at home and outdoors. The correct height and type of device are chosen by a therapist. Using an aid is not a sign of failure; instead, it is a way to stay active, prevent falls, and protect joints.

8. Home safety and fall-prevention changes
Simple changes at home can greatly reduce injury risk. Examples include removing loose rugs, using grab bars in the bathroom, adding good lighting, and keeping frequently used items at waist height. Stairs may need rails on both sides. An occupational therapist can walk through the home and suggest practical, low-cost safety improvements suited to the person’s daily routine.

9. Pain self-management techniques (non-drug)
Some people with CMT2Z have burning, tingling, or cramping pain. Non-drug methods include warm baths, heating pads (used carefully to avoid burns in numb areas), gentle massage, relaxation breathing, and mindfulness. These methods do not replace medicines when needed but can add extra relief, reduce stress, and improve sleep without extra side effects. Mayo Clinic

10. Strength and endurance training (low-impact)
Low-impact aerobic activities such as swimming, cycling, or walking in water can improve heart health and stamina without overloading weak muscles and joints. Short, regular sessions are better than rare, intense workouts. The goal is to stay active, prevent weight gain, and support mood and general health. Exercise plans should be made with a therapist or doctor to avoid over-work weakness. PMC+1

11. Weight management and healthy lifestyle
Extra body weight increases stress on already weak ankles, knees, and hips and can make walking harder. A dietitian can help create a balanced meal plan that maintains a healthy weight without extreme dieting. Staying active, avoiding smoking, and limiting alcohol also protect nerves, heart, and bones, which is important in a long-term condition like CMT2Z.

12. Psychological counselling and mental health support
Living with a rare, chronic condition can cause sadness, anxiety, or frustration. Talking with a psychologist, counsellor, or social worker helps many people cope. They can teach coping skills, support problem-solving at school or work, and help with body-image and confidence. Support is also important for parents and other family members.

13. Support groups and patient organizations
Meeting others with CMT or CMT2Z, in person or online, can reduce feelings of isolation. Patient groups share practical tips, news about research, and emotional support. They can also help families understand what to expect over time and how to advocate for services in schools, workplaces, and health systems. Charcot-Marie-Tooth Association+1

14. Genetic counselling and family planning advice
CMT2Z is usually autosomal dominant, which means a person with the condition has a chance to pass it to each child. Genetic counsellors explain this risk in simple terms and discuss options like testing other family members or planning future pregnancies. They also help families understand test results and how they relate to symptoms. NCBI+2Monarch Initiative+2

15. School and workplace adaptations
Young people may need extra time for writing, keyboards instead of handwriting, lifts instead of stairs, or rest breaks. Adults may need flexible hours, ergonomic chairs, or adjusted duties. Occupational therapists and doctors can write reports to support these changes so that learning and working remain possible and safe.

16. Hand therapy and fine-motor training
When hand muscles weaken, tasks such as writing, typing, playing instruments, or using tools become harder. Hand therapists can teach specific strengthening exercises for small muscles, give splints to support weak joints, and suggest adapted tools with larger grips. This helps maintain independence for longer.

17. Respiratory and speech therapy (if needed)
Most people with CMT2Z do not have serious breathing problems, but a small number may develop weakness of breathing or bulbar muscles. In such cases, respiratory therapists may teach breathing exercises or recommend devices to support breathing at night. Speech and swallowing therapists can help with speech clarity and safe swallowing if it becomes affected. Frontiers

18. Orthopaedic monitoring of spine and joints
Because of muscle imbalance, some people develop scoliosis (spine curve) or foot deformities like high arches and hammertoes. Regular checks by an orthopaedic specialist allow early use of braces, footwear changes, or, if needed, surgery before deformities become fixed and painful. ScienceDirect

19. Podiatry and skin care
Reduced feeling in the feet means cuts or blisters may go unnoticed and become infected. Regular visits to a podiatrist help keep nails trimmed, remove hard skin safely, and spot problems early. Learning to inspect the feet daily with a mirror and to choose socks and shoes that fit well is a simple but powerful habit.

20. Education about “nerve-safe” lifestyle
Education for the person and family covers topics like avoiding very tight shoes, not walking barefoot on hot surfaces, protecting the feet from burns, and avoiding known nerve-toxic drugs when possible (for example, some chemotherapy drugs – always ask the specialist). This knowledge helps people make safer choices over their whole life. ScienceDirect+1

Drug treatments

Important: No medicine can cure CMT2Z or stop it completely. All drugs below are used to treat symptoms such as nerve pain, cramps, mood problems, or sleep. Many are not specifically approved for CMT2Z, but are approved for neuropathic pain or related problems and may be used “off-label” by doctors. Doses here are typical adult ranges; children and teens need individual dosing by a specialist. Never start or change medicine without a doctor. PMC+2ScienceDirect+2

1. Pregabalin
Pregabalin is an anti-seizure drug that is widely used for nerve pain. It reduces the release of pain-signalling chemicals in the nervous system. It is FDA-approved for diabetic nerve pain, post-herpetic neuralgia, and other neuropathic pains, and doctors sometimes use it in CMT-related pain. Typical adult dosing starts at 150 mg per day, divided in 2–3 doses, and can be increased up to 300–600 mg per day depending on effect and kidney function. Common side effects include dizziness, sleepiness, weight gain, and swelling of legs. FDA Access Data+2FDA Access Data+2

2. Duloxetine
Duloxetine is an antidepressant in the SNRI class that also treats nerve pain. It increases serotonin and noradrenaline levels, which damp down pain messages in the spinal cord and brain. It is FDA-approved for diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. Usual adult dosing is 60 mg once daily, sometimes starting at 30 mg to improve tolerability. Side effects can include nausea, dry mouth, sleep changes, sweating, and increased blood pressure in some people. FDA Access Data+2FDA Access Data+2

3. Gabapentin
Gabapentin is another anti-seizure medicine commonly used for nerve pain and sometimes for sleep problems in neuropathy. It reduces abnormal firing in damaged nerves. Adults often start at 300 mg at night, increasing gradually to 900–3600 mg per day in divided doses if needed and tolerated. It can cause dizziness, drowsiness, and ankle swelling, so doses are increased slowly and adjusted in kidney disease.

4. Amitriptyline
Amitriptyline is a tricyclic antidepressant that in low doses helps with nerve pain and sleep. It blocks reuptake of serotonin and noradrenaline and has direct effects on sodium channels in pain fibers. For adults, doctors often start with 10–25 mg at night and increase slowly. It can cause dry mouth, constipation, blurred vision, weight gain, and daytime sleepiness, so careful monitoring is needed.

5. Nortriptyline
Nortriptyline is similar to amitriptyline but sometimes has fewer side effects. It also acts on serotonin and noradrenaline pathways. Doses often start at 10–25 mg at night, increasing based on response. It can help with neuropathic pain and sleep, but may cause dry mouth, constipation, and changes in heart rhythm at higher doses, so ECG monitoring may be needed in older adults.

6. Carbamazepine
Carbamazepine is an anti-seizure drug used mainly for trigeminal neuralgia but sometimes for other nerve pains. It stabilizes over-active sodium channels in nerves. Typical adult doses range from 400–1200 mg per day in divided doses. Side effects include dizziness, low blood counts, liver enzyme changes, and rare serious skin rashes, so blood tests are important.

7. Oxcarbazepine
Oxcarbazepine is related to carbamazepine and may be used when carbamazepine is not tolerated. It also blocks sodium channels to reduce pain signals. Adult dosing often starts at 300 mg twice daily and may be increased. Common side effects include dizziness, tiredness, and low sodium levels in the blood, which can cause confusion or headaches.

8. Tramadol
Tramadol is a weak opioid with extra effects on serotonin and noradrenaline. It may be used for moderate pain that does not respond to other medicines. Adult doses are commonly 50–100 mg every 4–6 hours as needed, up to a daily maximum set by the doctor. It can cause nausea, constipation, sleepiness, and, rarely, addiction or seizures, so it is used carefully and usually for short periods.

9. Topical lidocaine patches or creams
Lidocaine applied on the skin numbs the area and can help localized burning pain or allodynia (pain from light touch). Patches are usually worn for up to 12 hours on, 12 hours off, on painful areas like the feet. Systemic side effects are low, but skin irritation or rash can occur.

10. Capsaicin cream or high-strength patch
Capsaicin, from chili peppers, reduces pain by depleting a chemical called substance P from nerve endings. Low-strength creams are applied several times daily, while high-strength patches are applied in clinics. Burning and redness at the site are common at first but often decrease with time. It may help some people with nerve pain in the feet.

11. NSAIDs (e.g., naproxen, ibuprofen)
Non-steroidal anti-inflammatory drugs like naproxen and ibuprofen do not treat nerve damage itself, but they can help with joint and muscle pain due to abnormal walking or overuse. They are usually taken in the lowest effective dose and for short periods, because long-term use can affect the stomach, kidneys, and heart.

12. Acetaminophen (paracetamol)
Acetaminophen is often used for mild pain or as an add-on to other treatments. It works in the brain to reduce pain signals but does not treat nerve damage. When used within recommended daily limits and without alcohol, it is generally safe, but overdose can seriously damage the liver.

13. Baclofen
Baclofen is a muscle relaxant used when there are painful muscle spasms or increased tone (pyramidal signs) in some CMT2Z patients. It works on GABA-B receptors in the spinal cord to calm over-active nerve circuits. Doses start low and increase slowly to avoid drowsiness, weakness, or dizziness.

14. Tizanidine
Tizanidine is another muscle relaxant that acts on alpha-2 receptors to reduce spasticity. It can help with cramps and stiffness. Side effects include low blood pressure, sleepiness, and dry mouth, so it must be titrated carefully and not combined with certain other medicines.

15. Sertraline or other SSRIs
Selective serotonin reuptake inhibitors such as sertraline treat depression and anxiety, which are common in chronic neurological diseases. Improving mood can also reduce the experience of pain and increase activity levels. Doses and side effects depend on the specific drug, but may include nausea, sleep changes, or headaches.

16. Venlafaxine
Venlafaxine is an SNRI like duloxetine and may help with both mood and some neuropathic pain. It increases serotonin and noradrenaline. Doses are increased slowly to avoid blood pressure rises and withdrawal symptoms if stopped suddenly.

17. Melatonin (for sleep support)
Melatonin is a hormone used as a supplement to improve sleep onset and quality. Good sleep makes chronic pain and fatigue easier to manage. Typical doses are low (e.g., 1–5 mg at bedtime). Side effects are usually mild, such as morning sleepiness or vivid dreams.

18. Vitamin D (if deficient)
If blood tests show vitamin D deficiency, supplementation can support bone and muscle health. Weak bones are more likely to fracture in falls, so correcting deficiency is important. Dose depends on blood levels and local guidelines.

19. B-vitamin combination (if deficient)
In people with low B1, B6, or B12, replacing these vitamins is essential, because deficiency can worsen nerve damage. However, very high doses of B6 taken for a long time can itself cause neuropathy, so dosing must be guided by blood tests and a doctor.

20. Anti-spasticity botulinum toxin (selected cases)
In rare cases with focal spasticity or very tight muscles, botulinum toxin injections may be used to relax specific muscles. The medicine blocks acetylcholine release at the neuromuscular junction. Effects last about 3 months and can improve positioning and comfort, though injections must be repeated and are done only by trained specialists.

Dietary molecular supplements

Evidence for supplements in CMT2Z is still limited. They may support general nerve health but do not replace standard medical and rehab care. Always discuss with a doctor, especially if you take other medicines.

1. Alpha-lipoic acid – An antioxidant that can scavenge harmful free radicals and improve blood flow to nerves. In diabetic neuropathy, doses of about 300–600 mg per day have been studied. It may help reduce burning and tingling, but evidence in CMT is weak. It can cause mild stomach upset or skin rash.

2. Acetyl-L-carnitine – Important for energy production in mitochondria. Some small studies in neuropathy suggest it may support nerve regeneration and reduce pain. Typical doses are 500–1000 mg two or three times daily. Side effects are usually mild (nausea, restlessness), but high doses may cause stomach upset.

3. Coenzyme Q10 (ubiquinone) – A mitochondrial co-factor with antioxidant effects. It may support energy production in nerve and muscle cells. Doses often range from 100–300 mg per day with food. It is generally well tolerated but can cause mild digestive discomfort.

4. Omega-3 fatty acids (EPA/DHA) – Found in fish oil and some plant oils. Omega-3s have anti-inflammatory and possible neuroprotective effects. They may support heart health and reduce joint stiffness. Typical doses are 1–3 g per day of combined EPA/DHA from food and supplements, watching for interactions with blood-thinners.

5. Vitamin B12 (methylcobalamin) – Essential for myelin and nerve function. If levels are low or borderline, supplements can improve nerve health. Doses range from oral tablets to periodic injections, depending on deficiency severity. Side effects are rare, but monitoring levels is wise.

6. Vitamin B1 (thiamine or benfotiamine) – Important for nerve energy metabolism. Benfotiamine has been studied in diabetic neuropathy. Doses vary (e.g., 150–300 mg per day). It is usually safe but should be guided by a doctor if combined with other B-vitamins.

7. Vitamin D – As noted above, correcting vitamin D deficiency supports bone strength and muscle function. Doses depend on levels; common daily doses are 800–2000 IU, but sometimes higher short-term courses are used under supervision.

8. Magnesium – May help muscle cramps and improve sleep. Typical supplemental doses are 200–400 mg in the evening, but too much magnesium can cause diarrhoea or, in kidney disease, more serious problems.

9. Curcumin (from turmeric) – Has anti-inflammatory and antioxidant properties and might modulate pathways related to nerve inflammation. Absorption is better with pepper or special formulations. Doses in studies often range from 500–1500 mg per day. Side effects can include stomach upset or reflux.

10. Resveratrol – An antioxidant found in grapes and berries. Animal studies suggest possible neuroprotective effects, but human data are limited. Supplements are often 100–500 mg per day. It may interact with blood-thinning medications.

Regenerative / stem-cell-related and immunity-supporting therapies

At present, there are no approved stem-cell or gene-therapy drugs for CMT2Z in routine clinical use. Research is ongoing. The points below describe research directions and general immune-support ideas, not standard treatments. PMC+2ScienceDirect+2

1. Gene-targeted therapies (experimental) – Researchers are exploring ways to correct or silence faulty MORC2 genes, using gene editing or gene-silencing technologies. These are still in early stages and not available as regular care.

2. Neuroprotective small molecules – Studies are looking at drugs that may protect nerve cells from damage caused by abnormal MORC2 function, such as molecules that stabilise its ATPase activity. These are in pre-clinical or early clinical phases.

3. Mesenchymal stem-cell therapies (research) – Some centres are studying stem-cell infusions for peripheral neuropathies to see if they can release growth factors that support nerve repair. Evidence is not strong enough yet to recommend routine use, and unregulated “stem-cell clinics” should be avoided.

4. Induced pluripotent stem cells (iPSC) for modelling – Patient-derived iPSCs are being used to model CMT2Z in the lab. This helps scientists test potential drugs on nerve cells made from the patient’s own cells, moving towards personalised treatments in the future. Frontiers+1

5. Immune-supportive lifestyle – Good sleep, balanced diet, regular movement, vaccinations, and stress management all help the immune system function well, which indirectly supports nerve health and reduces infection risk.

6. Clinical trial medicines – Some people with CMT may be able to join clinical trials of new gene or drug treatments. A neurologist or rare-disease centre can check current trials and discuss whether they are appropriate.

Surgeries

1. Foot deformity correction (osteotomy) – When high arches or severe hammertoes cause pain, ulcers, or trouble fitting shoes, surgeons can cut and realign bones in the foot. This aims to improve weight distribution, reduce pain, and make walking and footwear easier.

2. Tendon transfer surgery – In foot drop, stronger tendons can be moved to take over the work of weak muscles, helping to raise the front of the foot. This can improve walking and reduce trips. Surgery is usually considered when braces alone are not enough.

3. Ankle or foot joint fusion (arthrodesis) – For very unstable, painful joints that do not respond to braces or therapy, fusing the joint in a better position can provide lasting stability. The trade-off is loss of movement at that joint, but overall walking can become safer and less painful.

4. Spinal surgery for scoliosis – If a curved spine becomes severe and causes pain or breathing problems, especially in growing children, spinal fusion surgery may be proposed. The goal is to stop the curve from worsening and to support lung function and posture.

5. Nerve decompression procedures – In selected cases where a nerve is pinched at a narrow point (such as the peroneal nerve at the fibular head), decompression surgery may reduce pain or improve function. Evidence is mixed, so surgeons choose cases carefully.

Prevention

1. Avoid known nerve-toxic drugs when possible (for example, some chemotherapy agents – always tell doctors you have CMT2Z).

2. Keep a healthy body weight to reduce load on weak joints and improve mobility.

3. Do regular, gentle physical activity and stretching to maintain strength and flexibility.

4. Wear well-fitting, supportive footwear and use orthoses as recommended.

5. Check feet daily for cuts, blisters, and pressure sores; treat minor problems early.

6. Make home safety changes to reduce falls (good lighting, grab bars, remove tripping hazards).

7. Stay up to date with vaccinations, especially against flu and pneumonia, to reduce illness that could weaken you further.

8. Avoid smoking and limit alcohol, as they can worsen nerve damage and overall health.

9. Attend regular follow-up with neurology, rehabilitation, and orthopaedic teams.

10. Offer genetic counselling to family members so they understand risks and can plan ahead.

When to see doctors

You should see a doctor (ideally a neurologist familiar with CMT) regularly, even when you feel stable, to monitor changes and adjust treatment. Seek medical help sooner if you notice:

• Rapid worsening of weakness, balance, or walking over weeks or months.

• New severe pain, burning, or cramps that interfere with sleep or daily life.

• Frequent falls or new injuries.

• New breathing problems, morning headaches, or trouble lying flat.

• Problems swallowing, choking, or major voice changes.

• Signs of foot infection such as redness, warmth, swelling, pus, or fever.

• Low mood, anxiety, or thoughts of hopelessness that last more than two weeks.

For serious symptoms like sudden trouble breathing, chest pain, or signs of severe infection, emergency care is needed.

What to eat and what to avoid

1. Eat: a wide variety of vegetables and fruits every day for vitamins and antioxidants.

2. Eat: whole grains (brown rice, oats, whole-wheat bread) instead of refined grains to support steady energy and weight control.

3. Eat: lean proteins such as fish, eggs, beans, lentils, and poultry to provide building blocks for muscles and nerves.

4. Eat: healthy fats from nuts, seeds, olive oil, and oily fish (omega-3s) that support heart and possibly nerve health.

5. Eat: calcium- and vitamin-D-rich foods (dairy, fortified foods) to help bones stay strong.

6. Avoid / limit: large amounts of sugary drinks, sweets, and highly processed snacks that add calories but few nutrients.

7. Avoid / limit: very salty and very fatty fast food, which can raise blood pressure and weight.

8. Avoid: heavy alcohol use, as it can damage nerves and increase falls.

9. Avoid: extreme diets or supplement “megadoses” without medical advice; they can cause harm or interact with medicines.

10. Aim for: regular meal times, good hydration, and fibre-rich foods to support digestion and overall energy.

Frequently asked questions

1. Is CMT2Z curable?
No. At this time, CMT2Z cannot be cured. Treatment focuses on managing symptoms, protecting function, and preventing complications using therapy, braces, medicines for pain, and, in some cases, surgery.

2. Will CMT2Z shorten life expectancy?
For most people, CMT2Z mainly affects movement and sensation and does not directly shorten life. However, severe disability, falls, and rare breathing problems can affect health, so regular medical follow-up is important. Mayo Clinic+1

3. Is CMT2Z always inherited from a parent?
CMT2Z is usually autosomal dominant, so one changed copy of the gene is enough to cause disease. Sometimes it is inherited from an affected parent; sometimes it appears for the first time as a new (de novo) mutation. Genetic testing and counselling explain the pattern in each family. NCBI+1

4. Can exercise make CMT2Z worse?
Gentle, well-planned exercise is helpful and usually does not make the disease worse. Very hard or prolonged exercise that severely over-tires weak muscles may cause temporary worsening. Working with a physiotherapist to design a safe program is the best approach. PMC+1

5. Can children with CMT2Z go to normal school?
Yes, most can. They may need extra help such as ramps, lifts, extra time for writing, or devices like laptops. Early communication with teachers and school health staff helps create a supportive environment.

6. Will I end up in a wheelchair?
Some people with CMT2Z may need a wheelchair for long distances or later in life, but many remain able to walk short distances with braces or aids. Good therapy, orthoses, and weight control can delay or reduce the need for a wheelchair.

7. Are there special shoes for CMT2Z?
Supportive shoes with good ankle support, stiff soles, and room for orthoses are recommended. A podiatrist or orthotist can help choose the right shoes and insoles.

8. Is pregnancy safe if I have CMT2Z?
Many people with CMT have successful pregnancies, but extra planning is needed. Genetic counselling can explain the risk of passing on the condition. Obstetric and anaesthetic teams need to know about CMT to plan safe pain control and delivery.

9. Can CMT2Z affect breathing?
Most people do not have serious breathing problems, but some may develop weakness of breathing muscles or spine curve that affects lungs. If you notice new breathlessness, morning headaches, or poor sleep, tell your doctor promptly.

10. Will medicines for nerve pain make me addicted?
Most nerve-pain medicines (like pregabalin, duloxetine, gabapentin) are not opioids and have low addiction risk when used correctly. Tramadol and other opioids can cause dependence if misused, so doctors use them carefully and often for short periods. FDA Access Data+2ilmeridian.com+2

11. Should my brothers and sisters be tested?
This depends on family plans and local guidelines. Genetic counselling can help each family member decide whether testing is right for them, based on age, symptoms, and personal wishes.

12. Are there foods that “cure” CMT2Z?
No food or supplement can cure CMT2Z. However, a balanced diet, healthy weight, and enough vitamins like D and B12 support overall health, bone strength, and muscle function, which helps you live better with the condition.

13. Can I play sports?
Many people can do low-impact sports such as swimming, cycling, or non-contact games. Activities with high risk of ankle injury or falls (like intense football, basketball, or jumping sports) may need modification. Always discuss with your doctor or physiotherapist.

14. How often should I see my neurologist?
This varies, but many people are reviewed every 6–12 months, or more often during periods of change (new symptoms, equipment, or surgery planning). Children may need closer monitoring during growth spurts.

15. Where can I find more information and research updates?
National CMT organisations, rare-disease groups, and specialist neuromuscular clinics provide reliable information about CMT2Z, clinical trials, and support services. Your neurologist can recommend trusted websites and local resources. Charcot-Marie-Tooth Association+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: December 23, 2025.